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Identification of primary and secondary measles vaccine failures by measurement of immunoglobulin G avidity in measles cases during the 1997 São Paulo epidemic.
Clin Diagn Lab Immunol. 2004 Jan; 11(1):119-22.CD

Abstract

Despite almost universal use of measles vaccines in recent decades, epidemics of the disease continue to occur. Understanding the role of primary vaccine failure (failure to seroconvert after vaccination) and secondary vaccine failures (waning immunity after seroconversion) in measles epidemics is important for the evaluation of measles control programs in developing countries. After a measles epidemic in São Paulo, Brazil, 159 cases previously confirmed by detection of specific immunoglobulin M (IgM) antibodies were tested for IgG avidity, and a secondary immune response, defined by an IgG avidity index of at least 30%, was established in 30 of 159 (18.9%) patients. Among the 159 patients, 107 (67.3%) had not been vaccinated and 52 (32.7%) had received one or more doses of measles vaccine. Of the 107 unvaccinated patients, 104 (97.2%) showed a primary immune response, defined as an IgG avidity index of less than 30%. Among the 52 patients with documented vaccination, 25 (48.1%) showed a primary immune response and 27 (51.9%) showed a secondary immune response, thereby constituting a secondary vaccine failure. Primary vaccine failure was observed in 13 of 13 patients vaccinated prior to 1 year of age and in 43.5 and 12.5%, respectively, of patients receiving one or two doses after their first birthdays. These results provide evidence that measurement of IgG avidity can be used to distinguish between primary and secondary vaccine failures in vaccinated patients with measles; the method can also be a useful tool for the evaluation of measles control programs.

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Authors+Show Affiliations

Pannuti CS
Instituto de Medicina Tropical de São Paulo-LIM-HC, Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. cpannuti@usp.br
Morello RJ
No affiliation info available
Moraes JC
No affiliation info available
Curti SP
No affiliation info available
Afonso AM
No affiliation info available
Camargo MC
No affiliation info available
Souza VA
No affiliation info available

MeSH

AdolescentAdultAntibodies, ViralAntibody AffinityBrazilChildChild, PreschoolDisease OutbreaksHumansImmunization ScheduleImmunoglobulin GInfantMeaslesMeasles VaccineMeasles virusTreatment Failure

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14715557

Citation

Pannuti, Cláudio S., et al. "Identification of Primary and Secondary Measles Vaccine Failures By Measurement of Immunoglobulin G Avidity in Measles Cases During the 1997 São Paulo Epidemic." Clinical and Diagnostic Laboratory Immunology, vol. 11, no. 1, 2004, pp. 119-22.
Pannuti CS, Morello RJ, Moraes JC, et al. Identification of primary and secondary measles vaccine failures by measurement of immunoglobulin G avidity in measles cases during the 1997 São Paulo epidemic. Clin Diagn Lab Immunol. 2004;11(1):119-22.
Pannuti, C. S., Morello, R. J., Moraes, J. C., Curti, S. P., Afonso, A. M., Camargo, M. C., & Souza, V. A. (2004). Identification of primary and secondary measles vaccine failures by measurement of immunoglobulin G avidity in measles cases during the 1997 São Paulo epidemic. Clinical and Diagnostic Laboratory Immunology, 11(1), 119-22.
Pannuti CS, et al. Identification of Primary and Secondary Measles Vaccine Failures By Measurement of Immunoglobulin G Avidity in Measles Cases During the 1997 São Paulo Epidemic. Clin Diagn Lab Immunol. 2004;11(1):119-22. PubMed PMID: 14715557.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Identification of primary and secondary measles vaccine failures by measurement of immunoglobulin G avidity in measles cases during the 1997 São Paulo epidemic. AU - Pannuti,Cláudio S, AU - Morello,Ricardo José, AU - Moraes,José Cássio de, AU - Curti,Suely Pires, AU - Afonso,Ana Maria S, AU - Camargo,Maria Cláudia Corrêa, AU - Souza,Vanda A U F de, PY - 2004/1/13/pubmed PY - 2004/4/16/medline PY - 2004/1/13/entrez SP - 119 EP - 22 JF - Clinical and diagnostic laboratory immunology JO - Clin Diagn Lab Immunol VL - 11 IS - 1 N2 - Despite almost universal use of measles vaccines in recent decades, epidemics of the disease continue to occur. Understanding the role of primary vaccine failure (failure to seroconvert after vaccination) and secondary vaccine failures (waning immunity after seroconversion) in measles epidemics is important for the evaluation of measles control programs in developing countries. After a measles epidemic in São Paulo, Brazil, 159 cases previously confirmed by detection of specific immunoglobulin M (IgM) antibodies were tested for IgG avidity, and a secondary immune response, defined by an IgG avidity index of at least 30%, was established in 30 of 159 (18.9%) patients. Among the 159 patients, 107 (67.3%) had not been vaccinated and 52 (32.7%) had received one or more doses of measles vaccine. Of the 107 unvaccinated patients, 104 (97.2%) showed a primary immune response, defined as an IgG avidity index of less than 30%. Among the 52 patients with documented vaccination, 25 (48.1%) showed a primary immune response and 27 (51.9%) showed a secondary immune response, thereby constituting a secondary vaccine failure. Primary vaccine failure was observed in 13 of 13 patients vaccinated prior to 1 year of age and in 43.5 and 12.5%, respectively, of patients receiving one or two doses after their first birthdays. These results provide evidence that measurement of IgG avidity can be used to distinguish between primary and secondary vaccine failures in vaccinated patients with measles; the method can also be a useful tool for the evaluation of measles control programs. SN - 1071-412X UR - https://www.unboundmedicine.com/medline/citation/14715557/Identification_of_primary_and_secondary_measles_vaccine_failures_by_measurement_of_immunoglobulin_G_avidity_in_measles_cases_during_the_1997_São_Paulo_epidemic_ DB - PRIME DP - Unbound Medicine ER -